Fine Feet

It’s been only about thirty minutes now (at least, as I’m writing this) since my annual appointment with my podiatrist. After fifteen quick minutes of discussion with the doc and then her examination, she told me everything is great and that she didn’t have any concerns.

I have to say that this year I didn’t have the same reservations I had my last go-round. Last year I worried about my feet. In fact, I wrote an entry about that visit. For some reason, my preoccupation with this visit was slim to none. In fact, I even had the appointment date wrong, and were it not for the doctor’s office calling me to confirm that my appointment was this morning, I’d have completely missed it.

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Do you go to the podiatrist? If not, why not? If so, what do you think of this medical experience versus the others that, as people with diabetes, you have quite frequently? Or, maybe I should rephrase that: Versus other medical experiences you should have frequently? The quarterly checkups for us persons with diabetes ought to be a given. However, I know there are many reasons that one might not make it to an endocrinologist (insurance issues, or lack of insurance; accessibility; mobility; and so on). That’s blog fodder for another day.

For the past three years, a podiatrist has been one more stop on the medical-office tour that’s become just another part of my existence. So how do I feel about going to the podiatrist, my 2011 assessment? Three visits, all told, and they’ve been the quickest, simplest medical visits I’ve ever gone to.

OK, so I don’t have any foot problems. At least, nothing major. I often fear I might be moving toward some type of foot problem. (See my previous feet blog entry in which I talk about my lack of treating my feet as a person with diabetes ought to.) Today, though, I passed the Semmes-Weinstein monofilament test with flying colors. I also rode the tuning-fork test to the end of its vibration against my big toe. Well, almost. I’m sure there was imperceptible vibration that I’m not picking up. But nothing major.

And I don’t cheat at those tests. Because I think about that. It’s like hearing tests or other medical exams where reaction or perception is being judged. A test anxiety sets in and I wonder if you can trick the doctor. Not that I would. And I asked my doctor this morning if people ever do try to guess the touch of the monofilament so they look as if they perform better, or do they guesstimate the stopping time of the tuning fork so their foot problems don’t seem as bad as they really are.

Yeah, I know, why would a person do that? It doesn’t benefit you at all to cheat when at the doctor. But we are human. How many of us delude ourselves about our health issues and say it’s not as bad as it actually is, or as we fear it may be, because we don’t want to know.

When confronted with a little foot quiz that has the potential to show you you’re not quite as with it (footwise) as you were last year, it might be attractive to tweak the results if you can.

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Natalie Sera

I find this an utterly confusing topic. I have had diabetes for 20 years now, and have been to a podiatrist exactly once, a couple of years ago, when I developed a fungus infection on my toenail. So he gave me some medicine for it, and it went away. He didn’t even tell me to come back, so I didn’t. I do look at my feet, and am fully capable of trimming my nails and doing “sensation tests” myself. I don’t have any noticeable calluses or corns, and I have perfect pain sensation (although I almost never have any foot pain) so I really can’t think of any reason for going to a podiatrist.

A CDE friend of mine said that if I have no foot problems, there is no reason to go to a podiatrist, and I have never seen any guidelines for people who don’t have any indications of trouble. (And by the way, I have no other complications, either).

I would be interested in having you or a guest poster examine this question in more detail, and NOT just for those who already have problems.

acampbell

Hi Natalie,

Your CDE friend is correct. If you do not have foot problems or aren’t “at risk” (meaning, you don’t have complications, such as neuropathy or retinopathy, you don’t smoke, and you’re able to see, reach and feel your feet), you do not need to see a podiatrist. However, your health-care provider should do a comprehensive foot exam on you every year as part of recommended diabetes care. This means evaluating for any pain or loss of sensation, checking the integrity of your skin, and checking your pulses to assess blood flow. Ideally, your provider or diabetes educator should discuss foot care, including appropriate shoes and socks to wear, how to check your feet at home, the use of skincare products, nail care, and what to do if you notice any problems, such as redness or cuts that don’t seem to be healing.

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